THE HEALTHCARE SYSTEM AND HEALTH SERVICE RESEARCH

Healthcare systems worldwide are constantly under transformational pressure which affects developed and emerging countries in different ways. Transformation requires political action to change regulation in order to provide for appropriate incentives for stakeholders and optimal outcome of healthcare services provided.  However, demand for reasonable reforms of healthcare systems can be met by health policy in different ways. In general, the acceptance of more evidence-based decision-making processes tends to growth. However, evidence-based policy has not been adopted widely. Instead, balance of key stakeholder interests is the most common procedure which often led to suboptimal outcome and resource allocation. The assessment and comparison of healthcare systems on a worldwide basis can help to understand performance and outcome differences. Furthermore, it produces normative implications which could be used for guidance and best practice development. Health service research is connected to health system related issues which represents it macro-level segment. This multidisciplinary area of scientific investigation studies how factors such as health technologies, organizational structures as for instance healthcare delivery processes, financing affect or influence access to healthcare, quality of life to mention a few targets. Health service research at our institute addresses the micro- (operational service delivery), meso- (organizational issues, processes) and macro-perspective (system, policy) of healthcare.

FOCUS OF OUR RESEARCH

The aim of our work is to explain to what extent new healthcare services, e.g. integrated care, affect the actual clinical situation of patients in a general clinical practice setting rather than in an experimental setting. Accordingly, health technology assessments (HTA) and comparative effectiveness research (CER) along with pragmatic clinical trial formats represent the pillars of our research.  Moreover, we also investigate the impacts of new legal regulations, e.g. co-payments and percentage excesses, on patients' everyday care as well as their behavior linked to compliance or adherence. Another research topic is the delegation of medical services along with the resulting performance taking different groups of healthcare professionals into account. This also comprises determining limiting and promoting parameters and developing feasible solutions based on several delegation configurations. Moreover, we focus on identifying factors, which influence – both positively and negatively - the acceptance and dissemination of innovative care concepts at an operational, organizational and system-related level. In doing so, our studies are not limited to certain disease patterns or medical interventions, but rather comprise a wide spectrum that ranges from frequently occurring diseases such as stroke, hypertension to organ transplantation.

ONE OF OUR CORE THEMES: DECISION CRITERIA FOR PRIORITY SETTING

In the light of cost pressure in statutory health insurance, the question arises more and more frequently how priorities can or must be set in healthcare considering scarcity of resources. If we can no longer afford to maximize therapeutic effort for all patients, what should be the decision criteria in favor of or against the application of a certain treatment? One of our core themes is the elaboration of scientific guidelines for priority setting decisions and decision-making processes, respectively.

COOPERATION

For our institute interdisciplinary partnering is a mission critical success factor and accordingly part of our “DNA”. Therefore, we perform scientific studies in this area by closely cooperating with involved stakeholders such as service providers (e.g. payors, health insurances, pension insurances) and healthcare providers (e.g. hospitals, physicians, pharmacists, nurses and other healthcare professionals). Furthermore, results deliver important data for the level of intervention of the healthcare system and allow for decisions to be taken on new treatment paths or on the networking of care providers.

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